Manic exhilaration

There’s a wonderful piece in yesterday’s British Medical Journal by Raquel Duarte, a fourth year medical student at Edinburgh University, on the sheer exhilaration of being with a manic patient.

She describes the first time she interviewed a manic patient during her attachment to a psychiatric ward.

…my patient sat down in the family room of the inpatient ward, and I proceeded to obtain a full, detailed psychiatric history‚Äîor rather, I tried to. The truth is, she just talked‚Äîabout everything from art, to politics, to literature. Because of my complete inability to direct the interview, I let her carry on. “Been here almost three hours already… Damn, shouldn’t have giggled at the SHO. Never mind, I’ll just have to come back again tomorrow.” Resigned to the fact that I’d have to meet this patient many times before I could get all the relevant facts, I relaxed and was surprised to find myself enjoying all the irrelevant bits of the conversation.

We both laughed and chuckled like a couple of schoolgirls, me and this 65 year old woman, as I got caught up in her contagious joy and boundless energy. Amid deliberations on Monet and reflections on the situation in the Middle East, she told me about her experience of terrible confusion that somehow, like in a dream, makes perfect sense. I heard about her tragic losses and deep despair, about the havoc this disease can wreck on a family and about how her faith had sustained her throughout. “Mania… psychosis… depression.” She didn’t just give me a history of bipolar illness, she told me a story and took me on a journey to discover a person struggling with a disease but who, in spite of or perhaps because of it, was a whole and wonderful human being.

Unfortunately, the whole piece is not freely available available online, but for those who can access the BMJ, you can read it here.